A plant habitat adapted design of an inner courtyard

Bostadsrättsförening Insjön 2 i Malmö ville ha sin gård renoverad. Uppdraget var att skapa en lättskött grönskade gård som var intressant året om. I allt för många fall på offentlig eller halvoffentliga platser likt denna bostadsgård resulterar grönytor ofta i monokulturer och statiska växtkompositioner. Viljan att istället skapa planteringar med stor dynamik och mångfald ledde fram till frågeställningarna om en bostadsgård kan gestaltas med stor artrikedom utan att kräva intensiv skötsel, samt vilka åtgärder som kan behöva göras för att skapa långsiktigt hållbara planteringar. En litteraturstudie genomfördes kring staden som ståndort, växters överlevnadsstrategier samt växtkomposition och växtval ur ett skötselperspektiv. Även intervjuer med fackmän inom projektering för grönytor användes för att få svar på frågeställningarna. Utöver det gjordes en ståndortsanalys för att sedan kunna hitta växtval som passade till platsen. Slutsatsen och svaret på frågeställningarna är att artrika planteringar utan ett intensivt skötselbehov är möjligt. Detta genom att välja växter anpassade för den aktuella ståndorten, att undvika invasiva arter, men också genom att använda stress eller störningsfaktorer i planteringen. Detta för att dessa faktorer begränsar tillväxten av ogräs samt att det hindrar näringsgynnade valda arter att ta över planteringen, så att mångfalden kan bevaras över tid. För att inte skötseln ska bli stor krävs också en acceptans för dynamik och succession. Dessutom en kunskap om vilka skötselinsatser som bör göras framförallt vid etableringen men också löpande för att miljön i växtsamhället inte ska förändras. En vägledning i skötseln kan vara att skicka med en skötselbeskrivning till beställaren. Övriga åtgärder för att skapa långsiktig hållbara planteringar är att konstruera växtbäddar utifrån den aktuella ståndorten och ta hänsyn till den underliggande terrassen. Detta för att luft- och vattentransport ska kunna ske mellan jordskikten. I stor uträckning bör rotogräsfri och naturligt bildade jordar användas som växtjord istället för tillverkade. Detta för att tillverkade jordar saknar biologiskt aktivitet och sällan är stabila i sin struktur, vilket kan innebära stora sättningar när organiskt material bryts ner.The housing cooperative Insjön 2 in Malmö, Sweden, wanted a renovation of its courtyard. The mission was to create a low-maintenance and lush courtyard that would be interesting all year round. In too many public and semi-public places like this courtyard, green spaces turn out in monocultural and static plant compositions. The desire to instead create plantings with great dynamics and diversity led to questions whether or not a residential courtyard could be designed with a great diversity in species without requiring intensive maintenance, as well as which steps that may be needed in order to create sustainable plantings. A literature review was carried out investigating topics of the city as a plant habitat, survival strategies of plants, as well as plant-composition and selection of plants from a maintenance perspective. Furthermore, interviews were conducted with professionals within the field of planning for green spaces to answer the research questions. Additionally, a plant habitat analysis was made in order to make suitable plant selections for the site. The conclusion and the answer to the research questions is that plantings with a great diversity in species are possible without the need for high maintenance. This is possible by selecting plants that are suitable for the site, by avoiding invasive species as well as using stress or disturbance factors in planting. This is because these factors limit the growth of weeds while preventing nutritional favored species to take over the plantings so that the diversity can be maintained. In order to minimize maintenance there is also a need for acceptance of dynamics and succession. Furthermore, knowledge of what type of maintenance is required at both the establishing stage as well as continuously so that the plant-environment is not altered is also needed. One solution to this is to include maintenance-guidelines to the client. Other measure for creating sustainable plantings is to create plant beds based on the present plant habitat in regards to the underlying terrace. This should be done to insure sufficient air and water flow between the soil-levels. To a vast extent, weed-free, naturally formed soils should be used as plant-soil rather than manufactured soil. This due to the fact that manufactured soils lack biologic activity and are seldom structurally constant which can lead to great soil-subsidence when organic material decomposes

Daily Step Count and Incident Diabetes in Community-Dwelling 70-Year-Olds: A Prospective Cohort Study

Background: Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. Methods: This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. Results: During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). Conclusions: A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity

Broadband UBVR_CI_C Photometry of Horizontal-Branch and Metal-poor Candidates from the HK and Hamburg/ESO Surveys. I.

We report broadband UBV and/or BVR_CI_C CCD photometry for a total of 1857 stars in the thick-disk and halo populations of the Galaxy. The majority of our targets were selected as candidate field horizontal-branch or other A-type stars (FHB/A, N = 576), or candidate low-metallicity stars (N = 1221), from the HK and Hamburg/ESO objective-prism surveys. Similar data for a small number of additional stars from other samples are also reported. These data are being used for several purposes. In the case of the FHB/A candidates they are used to accurately separate the lower gravity FHB stars from various higher gravity A-type stars, a subsample that includes the so-called blue metal poor stars, halo and thick-disk blue stragglers, main-sequence A-type dwarfs, and Am and Ap stars. These data are also being used to derive photometric distance estimates to high-velocity hydrogen clouds in the Galaxy and for improved measurements of the mass of the Galaxy. Photometric data for the metal-poor candidates are being used to refine estimates of stellar metallicity for objects with available medium-resolution spectroscopy, to obtain distance estimates for kinematic analyses, and to establish initial estimates of effective temperature for analysis of high-resolution spectroscopy of the stars for which this information now exists

Do patient-reported measures of disease activity in rheumatoid arthritis vary between countries? Results from a Nordic collaboration

Objectives To investigate whether patient-reported outcomes vary across countries and are influenced by cultural/contextual factors. Specifically, we aimed to assess inter-country differences in tender joint count (TJC), pain and patient's global health assessment (PGA), and their impact on disease activity (DAS28-CRP) in RA patients from five Nordic countries. Methods We collected data (baseline, 3- and 12-months) from rheumatology registers in the five countries comprising RA patients starting a first ever MTX or a first ever TNF inhibitor (TNFi). In order to assess the role of context (=country), we separately modelled TJC, pain and PGA as functions of objective variables (CRP, swollen joint count, age, sex, calendar period and disease duration) with linear models. Analyses were performed at each time point and for both treatments. We further assessed the impact of inter-country differences on DAS28-CRP. Results A total of 27 645 RA patients started MTX and 19 733 started a TNFi. Crude inter-country differences at MTX start amounted to up to 4 points (28 points scale) for TJC, 10 and 27 points (0-100 scale) for pain and PGA, respectively. Corresponding numbers at TNFi start were 3 (TJC), 27 (pain) and 24 (PGA) points. All differences were reduced at 3- and 12-months, and attenuated when adjusting for the objective variables. The variation in predicted DAS28-CRP across countries amounted to Conclusions Inter-country differences in TJC, pain and PGA are greater than expected based on differences in objective measures, but have a small clinical impact on DAS28-CRP across countries.Peer reviewe

HHV-6B Induces IFN-Lambda1 Responses in Cord Plasmacytoid Dendritic Cells through TLR9

Human herpesvirus type 6B (HHV-6B) is a strong inducer of IFN-alpha and has the capacity to promote Th1 responses and block Th2 responses in vitro. In this study we addressed whether inactivated HHV-6B can also induce IFN lambda responses and to what extent interferons alpha and lambda affect Th1/Th2 polarization. We show that inactivated HHV-6B induced IFN-lambda1 (IL-29) but not IFN-lambda2 (IL-28A) responses in plasmacytoid DC and that this induction was mediated through TLR9. We have previously shown that HHV-6B promotes Th1 responses and blocks Th2 responses in both humans and mice. We now show that neutralization of IFN-alpha but not IFN-lambda1 blocked the HHV-6B-induced enhancement of Th1 responses in MLR, but did not affect the HHV-6-induced dampening of Th2 responses. Similarly, blockage of TLR9 counteracted HHV-6Bs effects on the Th1/Th2 balance. In addition, IFN-alpha but not IFN-lambda1 promoted IFN-gamma production and blocked IL-5 and IL-13 production in purified CD4+ T-cells. The lack of effect of IFN-lambda1 correlated with the absence of the IFN-lambda receptor IL-28Ralfa chain on the cell surface of both resting and activated CD4+ T-cells. We conclude that inactivated HHV-6B is a strong inducer of IFN-lambda1 in plasmacytoid DC and that this induction is TLR9-dependent. However, human CD4+ T-cells do not express the IFN-lambda receptor and are refractory to IFN-lambda1 treatment. The HHV-6B-induced alterations in the Th1/Th2 balance are instead mediated mainly through TLR9 and IFN-alpha

Neuropsychological outcome after cardiac arrest: a prospective case control sub-study of the Targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest trial (TTM2)

Background: This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods: This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses. Discussion: In this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA

Opportunities and challenges for real-world studies on chronic inflammatory joint diseases through data enrichment and collaboration between national registers : the Nordic example

RMD Open 2018;4:e000655. doi:10.1136/ rmdopen-2018-000655Peer reviewe